Provider Demographics
NPI:1952686701
Name:SANDERS, SUZANNE WAUGH (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:WAUGH
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5716 LOMITA VERDE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4201
Mailing Address - Country:US
Mailing Address - Phone:512-301-0108
Mailing Address - Fax:
Practice Address - Street 1:5716 LOMITA VERDE CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4201
Practice Address - Country:US
Practice Address - Phone:512-426-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC#1416101YP2500X
TXLMFT#3839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist